JMIR Rehabilitation and Assistive Technologies最新文献

{"title":"Navigation Training for Persons With Visual Disability Through Multisensory Assistive Technology: Mixed Methods Experimental Study.","authors":"Fabiana Sofia Ricci, Lorenzo Liguori, Eduardo Palermo, John-Ross Rizzo, Maurizio Porfiri","doi":"10.2196/55776","DOIUrl":"10.2196/55776","url":null,"abstract":"<p><strong>Background: </strong>Visual disability is a growing problem for many middle-aged and older adults. Conventional mobility aids, such as white canes and guide dogs, have notable limitations that have led to increasing interest in electronic travel aids (ETAs). Despite remarkable progress, current ETAs lack empirical evidence and realistic testing environments and often focus on the substitution or augmentation of a single sense.</p><p><strong>Objective: </strong>This study aims to (1) establish a novel virtual reality (VR) environment to test the efficacy of ETAs in complex urban environments for a simulated visual impairment (VI) and (2) evaluate the impact of haptic and audio feedback, individually and combined, on navigation performance, movement behavior, and perception. Through this study, we aim to address gaps to advance the pragmatic development of assistive technologies (ATs) for persons with VI.</p><p><strong>Methods: </strong>The VR platform was designed to resemble a subway station environment with the most common challenges faced by persons with VI during navigation. This environment was used to test our multisensory, AT-integrated VR platform among 72 healthy participants performing an obstacle avoidance task while experiencing symptoms of VI. Each participant performed the task 4 times: once with haptic feedback, once with audio feedback, once with both feedback types, and once without any feedback. Data analysis encompassed metrics such as completion time, head and body orientation, and trajectory length and smoothness. To evaluate the effectiveness and interaction of the 2 feedback modalities, we conducted a 2-way repeated measures ANOVA on continuous metrics and a Scheirer-Ray-Hare test on discrete ones. We also conducted a descriptive statistical analysis of participants' answers to a questionnaire, assessing their experience and preference for feedback modalities.</p><p><strong>Results: </strong>Results from our study showed that haptic feedback significantly reduced collisions (P=.05) and the variability of the pitch angle of the head (P=.02). Audio feedback improved trajectory smoothness (P=.006) and mitigated the increase in the trajectory length from haptic feedback alone (P=.04). Participants reported a high level of engagement during the experiment (52/72, 72%) and found it interesting (42/72, 58%). However, when it came to feedback preferences, less than half of the participants (29/72, 40%) favored combined feedback modalities. This indicates that a majority preferred dedicated single modalities over combined ones.</p><p><strong>Conclusions: </strong>AT is crucial for individuals with VI; however, it often lacks user-centered design principles. Research should prioritize consumer-oriented methodologies, testing devices in a staged manner with progression toward more realistic, ecologically valid settings to ensure safety. Our multisensory, AT-integrated VR system takes a holistic approach, offering a first ste","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"11 ","pages":"e55776"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mainstream Technologies in Facilities for People With Intellectual Disabilities: Multiple-Methods Study Using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability Framework.","authors":"Christian Menschik, Christophe Kunze, Gregor Renner, Theresa Etges","doi":"10.2196/59360","DOIUrl":"10.2196/59360","url":null,"abstract":"<p><strong>Background: </strong>People with intellectual disabilities in residential or outpatient facilities for people with disabilities run the risk of being digitally excluded by not having opportunities for taking advantage of digitalization possibilities.</p><p><strong>Objective: </strong>We aimed to investigate how disability caregivers and managers describe barriers and facilitating factors to implement and adopt mainstream technology for people with intellectual disabilities in residential or outpatient facilities and how the competencies and capabilities of the caregivers are assessed in the process.</p><p><strong>Methods: </strong>For this reason, we conducted a multiple-methods study applying the nonadoption, abandonment, scale-up, spread, and sustainability framework.</p><p><strong>Results: </strong>As a result, we identified barriers and facilitators across the nonadoption, abandonment, scale-up, spread, and sustainability framework domains: (1) condition-people with intellectual disabilities are a diverse group, where the individual condition of the person and, for example, their communication skills were seen as a prerequisite for implementing mainstream technologies; (2) technology-the extent to which mainstream technology fits the individual needs and demands contributed to the implementation process; (3) value proposition-communication was seen as a life area where mainstream technology can add value; (4) adopters-the caregivers needed competencies and capabilities to accompany their care recipients' technology use; (5) organization-missing legal regulations and lack of personnel resources were described as barriers; (6) wider context-funding opportunities were seen as unclear in disability services as mainstream technologies could not be financed as participation benefits; (7) embedding and adaptation over time-the COVID-19 pandemic forced facilities to become digitalized to some extent.</p><p><strong>Conclusions: </strong>The disability services investigated were still in need of standardized procedures to promote the digital participation of their residents.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"11 ","pages":"e59360"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capabilities for Using Telemonitoring in Physiotherapy Treatment: Exploratory Qualitative Study.","authors":"Charlotte van Westerhuis, Astrid F Sanders, Jesse J Aarden, Mel E Major, Marijke E de Leeuwerk, Nadine Florisson, Miriam H Wijbenga, Marike van der Schaaf, Marike van der Leeden, Maarten A van Egmond","doi":"10.2196/56432","DOIUrl":"10.2196/56432","url":null,"abstract":"<p><strong>Background: </strong>Telemonitoring (TM), as part of telehealth, allows physiotherapists to monitor and coach their patients using remotely collected data. The use of TM requires a different approach compared with face-to-face treatment. Although a telehealth capability framework exists for health care professionals, it remains unclear what specific capabilities are required to use TM during physiotherapy treatments.</p><p><strong>Objective: </strong>This study aims to identify the capabilities required to use TM in physiotherapy treatment.</p><p><strong>Methods: </strong>An exploratory qualitative study was conducted following a constructivist semistructured grounded theory approach. Three heterogeneous focus groups were conducted with 15 lecturers of the School of Physiotherapy (Bachelor of Science Physiotherapy program) from the Amsterdam University of Applied Sciences. Focus group discussions were audiotaped and transcribed verbatim. Capabilities for using TM in physiotherapy treatment were identified during an iterative process of data collection and analysis, based on an existing framework with 4 different domains. Team discussions supported further conceptualization of the findings.</p><p><strong>Results: </strong>Sixteen capabilities for the use of TM in physiotherapy treatment were found addressing 3 different domains. Four capabilities were identified in the \"digital health technologies, systems, and policies\" domain, 7 capabilities in the \"clinical practice and application\" domain, and 5 capabilities in the \"data analysis and knowledge creation\" domain. No capabilities were identified in the \"system and technology implementation\" domain.</p><p><strong>Conclusions: </strong>The use of TM in physiotherapy treatment requires specific skills from physiotherapists. To best use TM in physiotherapy treatment, it is important to integrate these capabilities into the education of current and future physiotherapists.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"11 ","pages":"e56432"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11527389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Approach Using Intuitionistic Fuzzy Multicriteria Decision-Making to Support Classifier Selection for Technology Adoption in Patients with Parkinson Disease: Algorithm Development and Validation.","authors":"Miguel Ortiz-Barrios, Ian Cleland, Mark Donnelly, Muhammet Gul, Melih Yucesan, Genett Isabel Jiménez-Delgado, Chris Nugent, Stephany Madrid-Sierra","doi":"10.2196/57940","DOIUrl":"10.2196/57940","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Parkinson disease (PD) is reported to be among the most prevalent neurodegenerative diseases globally, presenting ongoing challenges and increasing burden on health care systems. In an effort to support patients with PD, their carers, and the wider health care sector to manage this incurable condition, the focus has begun to shift away from traditional treatments. One of the most contemporary treatments includes prescribing assistive technologies (ATs), which are viewed as a way to promote independent living and deliver remote care. However, the uptake of these ATs is varied, with some users not ready or willing to accept all forms of AT and others only willing to adopt low-technology solutions. Consequently, to manage both the demands on resources and the efficiency with which ATs are deployed, new approaches are needed to automatically assess or predict a user's likelihood to accept and adopt a particular AT before it is prescribed. Classification algorithms can be used to automatically consider the range of factors impacting AT adoption likelihood, thereby potentially supporting more effective AT allocation. From a computational perspective, different classification algorithms and selection criteria offer various opportunities and challenges to address this need.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This paper presents a novel hybrid multicriteria decision-making approach to support classifier selection in technology adoption processes involving patients with PD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;First, the intuitionistic fuzzy analytic hierarchy process (IF-AHP) was implemented to calculate the relative priorities of criteria and subcriteria considering experts' knowledge and uncertainty. Second, the intuitionistic fuzzy decision-making trial and evaluation laboratory (IF-DEMATEL) was applied to evaluate the cause-effect relationships among criteria/subcriteria. Finally, the combined compromise solution (CoCoSo) was used to rank the candidate classifiers based on their capability to model the technology adoption.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We conducted a study involving a mobile smartphone solution to validate the proposed methodology. Structure (F5) was identified as the factor with the highest relative priority (overall weight=0.214), while adaptability (F4) (D-R=1.234) was found to be the most influencing aspect when selecting classifiers for technology adoption in patients with PD. In this case, the most appropriate algorithm for supporting technology adoption in patients with PD was the A3 - J48 decision tree (M3=2.5592). The results obtained by comparing the CoCoSo method in the proposed approach with 2 alternative methods (simple additive weighting and technique for order of preference by similarity to ideal solution) support the accuracy and applicability of the proposed methodology. It was observed that the final scores of the algorithms in each method were highly correlated (Pearson correlation coeffi","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"11 ","pages":"e57940"},"PeriodicalIF":0.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11521352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Home-Based Rehabilitation Program for Individuals With Disabilities: Longitudinal Observational Study.","authors":"Patricio Barría, Asterio Andrade, Daniel Gomez-Vargas, Alejandro Yelincic, Flavio Roberti, Eduardo Bahamonde, Rolando Aguilar, Bessie Cordova","doi":"10.2196/59915","DOIUrl":"10.2196/59915","url":null,"abstract":"<p><strong>Background: </strong>Disability affects a significant portion of the global population nowadays, necessitating innovative approaches to access rehabilitation processes. Home-based rehabilitation has emerged as a beneficial approach, offering comfort and context-specific therapy.</p><p><strong>Objective: </strong>This study aims to evaluate the impact of a multidisciplinary home-based rehabilitation program for individuals with moderate neuromusculoskeletal disabilities in terms of motor function and mood.</p><p><strong>Methods: </strong>A total of 270 participants with median age of 66 (IQR 20-98) years were recruited from the National Disability Registry of Chile. The intervention involved a multidisciplinary team composed of 49 health care professionals providing personalized treatment plans over 4 months (32 sessions for physical therapy, 8 sessions for occupational therapy, 4 sessions for nutrition, 8 sessions for psychology, and 4 sessions for nursing and podiatry). This program also included 2 medical evaluations (at the beginning and the end) to monitor clinical progress in terms of motor function and mental health, using the Berg Balance Scale and Beck Depression Inventory, respectively.</p><p><strong>Results: </strong>The home-based rehabilitation program showed significant improvements (P<.001) in motor function and balance with a reduction in fall risk. Specifically, the Berg Balance Scale score decreased close to 15% after the home-based rehabilitation program for all enrolled participants. On the other hand, depression levels showed no significant changes (P=.27), with percentages of variation less than 8% between the 2 assessed conditions. In this sense, participants remained with the same mild depression level (14 of 63) concerning the Beck Depression Inventory score.</p><p><strong>Conclusions: </strong>This study concludes that personalized home-based rehabilitation programs are effective in enhancing motor function and balance, particularly in individuals with neurological conditions. On the other hand, the findings in terms of mood advocate for further exploration of psychological support within such programs to enhance overall patient well-being.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06537791; https://clinicaltrials.gov/study/NCT06537791.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"11 ","pages":"e59915"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11525072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of the Design of Multimedia Patient Education Materials in Musculoskeletal Health Care: Systematic Review.","authors":"Garett Van Oirschot, Amanda Pomphrey, Caoimhe Dunne, Kate Murphy, Karina Blood, Cailbhe Doherty","doi":"10.2196/48154","DOIUrl":"10.2196/48154","url":null,"abstract":"<p><strong>Background: </strong>Educational multimedia is a cost-effective and straightforward way to administer large-scale information interventions to patient populations in musculoskeletal health care. While an abundance of health research informs the content of these interventions, less guidance exists about optimizing their design.</p><p><strong>Objective: </strong>This study aims to identify randomized controlled trials of patient populations with musculoskeletal conditions that used multimedia-based patient educational materials (PEMs) and examine how design was reported and impacted patients' knowledge and rehabilitation outcomes. Design was evaluated using principles from the cognitive theory of multimedia learning (CTML).</p><p><strong>Methods: </strong>PubMed, CINAHL, PsycINFO, and Embase were searched from inception to September 2023 for studies examining adult patients with musculoskeletal conditions receiving multimedia PEMs compared to any other interventions. The primary outcome was knowledge retention measured via test scores. Secondary outcomes were any patient-reported measures. Retrievability was noted, and PEMs were sourced through search, purchase, and author communication.</p><p><strong>Results: </strong>A total of 160 randomized controlled trials were eligible for inclusion: 13 (8.1%) included their educational materials and 31 (19.4%) required a web search, purchase, or direct requests for educational materials. Of these 44 (27.5%) studies, none fully optimized the design of their educational materials, particularly lacking in the CTML principles of coherence, redundancy, modality, and generative activities for the learner. Of the 160 studies, the remaining 116 (72.5%) contained interventions that could not be retrieved or appraised. Learning was evaluated in 5 (3.1%) studies.</p><p><strong>Conclusions: </strong>Musculoskeletal studies should use open science principles and provide their PEMs wherever possible. The link between providing multimedia PEMs and patient learning is largely unexamined, but engagement potential may be maximized when considering design principles such as the CTML.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":" ","pages":"e48154"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usage, Attitudes, Facilitators, and Barriers Toward Digital Health Technologies in Musculoskeletal Care: Survey Among Primary Care Physiotherapists in Norway.","authors":"Lars Martinsen, Nina Østerås, Tuva Moseng, Anne Therese Tveter","doi":"10.2196/54116","DOIUrl":"10.2196/54116","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Work burden increases for physiotherapists in the primary health care sector as the prevalence of musculoskeletal disorders (MSDs) increases. Digital health technologies (DHTs) are proposed as a viable solution to secure the sustainability of the health care system and have shown promising results in a range of conditions. However, little is known about use of DHTs among physiotherapists in the primary health care sector in Norway.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to investigate the use of and attitudes toward DHTs among physiotherapists treating patients with MSDs in primary care, and potential facilitators or barriers for adopting DHTs in clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An author-developed web-based questionnaire was distributed to physiotherapists in all Norwegian municipalities in March 2023. The questionnaire included items regarding use of technologies, attitudes, suitability, and factors influencing adoption of DHT. Suitability and agreement on statements were scored on an 11-point numeric rating scale (0=very unsuitable or strongly disagree, 10=very suitable or strongly agree). Differences across employment sites and users versus nonusers of DHT were analyzed using the χ&lt;sup&gt;2&lt;/sup&gt; test, Fisher exact test, Student t test, and Mann-Whitney U test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Approximately 5000 physiotherapists were invited to participate, of which 6.8% (338) completed the questionnaire. A total of 46.2% (156/338) offered DHTs in their practice, of which 53.2% (83/156) used it on a weekly basis, mostly telephone consultations (105/156, 67.3%). A higher proportion of physiotherapists in private practice offered DHT compared with those employed by municipalities (95/170, 55.9% vs 61/168, 36.3%; P&lt;.001). A majority (272/335, 81.2%) were positive about recommending DHTs to their patients. Suitability of DHTs in physiotherapy was rated an average of 6 (SD 2.1). Apps for smartphones or tablets were rated most suitable (mean rating 6.8, SD 2.4). The most frequently reported advantages were flexibility in how physiotherapy is offered (278/338, 82.3%) and reduced travel time for the patient (235/338, 70%). The highest rated disadvantages were limited scope for physical examination (252/338, 74.6%) and difficulty in building rapport with the patient (227/338, 67.2%). The main facilitators and barriers included a functioning (median rating 10, IQR 8-10) or lack of functioning (median rating 9, IQR 8-10) internet connection, respectively. Lack of training in DHTs was prominent regarding evaluation, diagnosing, and treatment (median rating 0, IQR 0-2), with minor, but significant, differences between nonusers and users (median rating 0, IQR 0-1 vs median rating 1, IQR 0-4); P&lt;.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Physiotherapists in Norwegian primary care treating patients with MSDs are positive about using DHTs, and almost 50% (156/338) have adopted them in clinical practice","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"11 ","pages":"e54116"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11443180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Participatory Model for Cocreating Accessible Rehabilitation Technology for Stroke Survivors: User-Centered Design Approach.","authors":"Andrew Kerr, Madeleine Grealy, Milena Slachetka, Chioma Obinuchi Wodu, Gillian Sweeney, Fiona Boyd, David Colville, Philip Rowe","doi":"10.2196/57227","DOIUrl":"10.2196/57227","url":null,"abstract":"<p><strong>Background: </strong>Globally, 1 in 3 people live with health conditions that could be improved with rehabilitation. Ideally, this is provided by trained professionals delivering evidence-based dose, intensity, and content of rehabilitation for optimal recovery. The widely acknowledged inability of global health care providers to deliver recommended levels of rehabilitation creates an opportunity for technological innovation. Design processes that lack close consideration of users' needs and budgets, however, mean that many rehabilitation technologies are neither useful nor used. To address this problem, our multidisciplinary research group have established a cocreation center for rehabilitation technology that places the end user at the center of the innovation process.</p><p><strong>Objective: </strong>This study aims to present the participatory cocreation model that has been developed from our center and illustrate the approach with 2 cases studies.</p><p><strong>Methods: </strong>The model is built around user participation in an intensive rehabilitation program (2-hour sessions, 2-5 times per week, and 8-week duration), supervised by qualified therapists but delivered exclusively through commercial and prototype technology. This provides participants (chronic stroke survivors with movement and/or speech disability) with a rich experience of rehabilitation technology, enabling them to provide truly informed feedback, as well as creating an observatory for the research team. This process is supported by short-term focus groups for specific product development and a longer-term advisory group to consider broader issues of adoption and translation into everyday health care.</p><p><strong>Results: </strong>Our model has been active for 3 years with 92 (92%) out of 100 participants completing the program. Five new technologies have evolved from the process with further ideas logged for future development. In addition, it has led to a set of cocreated protocols for technology-enriched rehabilitation, including recruitment, outcome measures, and intervention structure, which has allowed us to replicate this approach in an acute hospital ward.</p><p><strong>Conclusions: </strong>Suboptimal rehabilitation limits recovery from health conditions. Technology offers the potential support to increase access to recommended levels of rehabilitation but needs to be designed to suit end users and not just their impairment. Our cocreation model, built around participation in an intensive, technology-based program, has produced new accessible technology and demonstrated the feasibility of our overall approach to providing the rehabilitation that people need, for as long as needed.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"11 ","pages":"e57227"},"PeriodicalIF":0.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Facilitators to the Use of Wearable Robots as Assistive Devices: Qualitative Study With Older Adults and Physiotherapists.","authors":"Leah Reicherzer, Mandy Scheermesser, Adrian Kläy, Jaime E Duarte, Eveline S Graf","doi":"10.2196/52676","DOIUrl":"10.2196/52676","url":null,"abstract":"<p><strong>Background: </strong>Light wearable robots have the potential to assist older adults with mobility impairments in daily life by compensating for age-related decline in lower extremity strength. Physiotherapists may be the first point of contact for older adults with these devices.</p><p><strong>Objective: </strong>The aims of this study were to explore views of older adults and physiotherapists on wearable robots as assistive devices for daily living and to identify the barriers and facilitators to their use.</p><p><strong>Methods: </strong>Six older adults (aged 72-88 years) tested a wearable robot (Myosuit) and participated in semistructured interviews. A focus group with 6 physiotherapists who had a minimum of 5 years of professional experience and specialized in geriatrics was conducted. Data were analyzed using thematic qualitative text analysis.</p><p><strong>Results: </strong>Older adults perceived benefits and had positive use experiences, yet many saw no need to use the technology for themselves. Main barriers and facilitators to its use were the perception of usefulness, attitudes toward technology, ease of use, and environmental factors such as the support received. Physiotherapists named costs, reimbursement schemes, and complexity of the technology as limiting factors.</p><p><strong>Conclusions: </strong>A light wearable robot-the Myosuit-was found to be acceptable to study participants as an assistive device. Although characteristics of the technology are important, the use and acceptance by older adults heavily depend on perceived usefulness and need.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"11 ","pages":"e52676"},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11327840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Validity and Acceptability of Motion Tape for Measuring Low Back Movement: Mixed Methods Study.","authors":"Audrey Lee, Elijah Wyckoff, Emilia Farcas, Job Godino, Kevin Patrick, Spencer Spiegel, Rose Yu, Arun Kumar, Kenneth J Loh, Sara Gombatto","doi":"10.2196/57953","DOIUrl":"10.2196/57953","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is a significant public health problem that can result in physical disability and financial burden for the individual and society. Physical therapy is effective for managing LBP and includes evaluation of posture and movement, interventions directed at modifying posture and movement, and prescription of exercises. However, physical therapists have limited tools for objective evaluation of low back posture and movement and monitoring of exercises, and this evaluation is limited to the time frame of a clinical encounter. There is a need for a valid tool that can be used to evaluate low back posture and movement and monitor exercises outside the clinic. To address this need, a fabric-based, wearable sensor, Motion Tape (MT), was developed and adapted for a low back use case. MT is a low-profile, disposable, self-adhesive, skin-strain sensor developed by spray coating piezoresistive graphene nanocomposites directly onto commercial kinesiology tape.</p><p><strong>Objective: </strong>The objectives of this study were to (1) validate MT for measuring low back posture and movement and (2) assess the acceptability of MT for users.</p><p><strong>Methods: </strong>A total of 10 participants without LBP were tested. A 3D optical motion capture system was used as a reference standard to measure low back kinematics. Retroreflective markers and a matrix of MTs were placed on the low back to measure kinematics (motion capture) and strain (MT) simultaneously during low back movements in the sagittal, frontal, and axial planes. Cross-correlation coefficients were calculated to evaluate the concurrent validity of MT strain in reference motion capture kinematics during each movement. The acceptability of MT was assessed using semistructured interviews conducted with each participant after laboratory testing. Interview data were analyzed using rapid qualitative analysis to identify themes and subthemes of user acceptability.</p><p><strong>Results: </strong>Visual inspection of concurrent MT strain and kinematics of the low back indicated that MT can distinguish between different movement directions. Cross-correlation coefficients between MT strain and motion capture kinematics ranged from -0.915 to 0.983, and the strength of the correlations varied across MT placements and low back movement directions. Regarding user acceptability, participants expressed enthusiasm toward MT and believed that it would be helpful for remote interventions for LBP but provided suggestions for improvement.</p><p><strong>Conclusions: </strong>MT was able to distinguish between different low back movements, and most MTs demonstrated moderate to high correlation with motion capture kinematics. This preliminary laboratory validation of MT provides a basis for future device improvements, which will also involve testing in a free-living environment. Overall, users found MT acceptable for use in physical therapy for managing LBP.</p>","PeriodicalId":36224,"journal":{"name":"JMIR Rehabilitation and Assistive Technologies","volume":"11 ","pages":"e57953"},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}